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1679023501
LARA DENGERINK-VANTIL
GRAND RAPIDS, MI
NPI
1679023501
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: MI 4704302218)
Enumeration Date
2016-10-04
Last Update Date
2024-10-28
Business Address
LARA DENGERINK-VANTIL NP
25 MICHIGAN ST NE STE 2100
GRAND RAPIDS, MI 49503-2526
Phone number: 616-391-3777
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Mailing Address
LARA DENGERINK-VANTIL NP
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number:
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